{"id":3006,"date":"2017-03-29T13:20:47","date_gmt":"2017-03-29T12:20:47","guid":{"rendered":"https:\/\/bestpractice.bmj.com\/?page_id=3006"},"modified":"2026-01-20T17:45:43","modified_gmt":"2026-01-20T16:45:43","slug":"what-is-ebm","status":"publish","type":"page","link":"https:\/\/bestpractice.bmj.com\/info\/us\/evidence\/learn-ebm\/what-is-ebm\/","title":{"rendered":"What is EBM?"},"content":{"rendered":"<p class=\"lead\">Evidence-based medicine (EBM<sup>a<\/sup>) refers to the application of the best available research to clinical care, which requires the integration of evidence with clinical expertise and patient values.[1][2]&nbsp; By best available research, we mean clinically relevant (i.e., patient oriented) research that:<\/p><br \/>\r\n<br \/>\r\n<ul><br \/>\r\n \t<li>Illuminates the accuracy and precision of diagnostic tests,<\/li><br \/>\r\n \t<li>Highlights the importance of prognostic markers,<\/li><br \/>\r\n \t<li>Establishes the efficacy and safety of therapeutic, rehabilitative, or preventive healthcare strategies, or<\/li><br \/>\r\n \t<li>Seeks to understand the patient experience.<\/li><br \/>\r\n<\/ul><br \/>\r\nPhysicians must use their clinical skills and prior experience to rapidly identify each patient\u2019s unique clinical situation, applying the evidence tailored to the individual\u2019s risks versus benefits of potential interventions. Ultimately, the normative goal of EBM is to support the patient by contextualizing the evidence with their preferences, concerns, and expectations. This results in a process of <a href=\"https:\/\/bestpractice.bmj.com\/info\/toolkit\/practise-ebm\/shared-decision\/\" target=\"_blank\" rel=\"noopener\">shared decision making<\/a>, in which the patient\u2019s values, circumstances, and setting dictate the best care.<br \/>\r\n<br \/>\r\nThe widespread use of EBM in many healthcare disciplines<sup>b&nbsp;<\/sup> reflects its broad impact. EBM is also an important tool for social justice. If applied appropriately, it has the potential to be a great equalizer \u2013 striving for equitable care for patients in disparate parts of the world. Furthermore, EBM plays a prominent role in policy making; politicians are increasingly speaking to their use of research evidence to inform their decision making as a declaration of legitimacy.[3][4]<br \/>\r\n<br \/>\r\nIts history has been artfully described in \u2018an oral history of EBM\u2019, presented by Dr. Richard Smith, which includes discussions with the founders of EBM \u2013 including Drs David Sackett, Brian Haynes, and Gordon Guyatt.[5] Interested readers can also reference the James Lind Library, which outlines many seminal moments in EBM history.[6] The bottom line of these articles is that EBM is not a new concept but rather it reflects the work of countless people who have improved the process of generating clinical evidence over several decades, and that it continues to evolve.<br \/>\r\n<br \/>\r\nDeveloping the skills to practice EBM requires access to evidence, opportunities to practice, and time. We hope this portal will be a starting point. You might choose to use this resource to become a more savvy consumer of the literature or to become the next person to advance this collective wisdom. Much work remains: finding novel ways to integrate evidence into personal health records for use at the bedside and in the patient\u2019s home, improving strategies for risk communication, and finding ways to learn and practice medicine in the face of uncertainty are ripe for efforts.[7] We hope you\u2019ll join this ongoing conversation.<br \/>\r\n<br \/>\r\n<strong>Reena Pattani MD MPH FRCPC<\/strong><br \/>\r\nAssistant Professor,<br \/>\r\nDivision of General Internal Medicine<br \/>\r\nDepartment of Medicine<br \/>\r\nSt. Michael\u2019s Hospital<br \/>\r\nUniversity of Toronto<br \/>\r\n<br \/>\r\n<strong>Sharon E. Straus MD MSc FRCPC<\/strong><br \/>\r\nProfessor,<br \/>\r\nDivision of Geriatric Medicine<br \/>\r\nDepartment of Medicine<br \/>\r\nSt. Michael\u2019s Hospital<br \/>\r\nUniversity of Toronto<br \/>\r\n<br \/>\r\nAcknowledgements: SES is funded by a Tier 1 Canada Research Chair.<br \/>\r\n<br \/>\r\n<sup>a&nbsp;<\/sup>The term EBM is used interchangeably with evidence-based practice or evidence-based health care.<br \/>\r\n<sup>b&nbsp;<\/sup>Occupational therapy, physiotherapy, nursing, dentistry, and complementary medicine, to name a few.<br \/>\r\n<h3>&nbsp;Related blog<\/h3><br \/>\r\n<a href=\"https:\/\/bestpractice.bmj.com\/info\/toolkit\/discuss-ebm\/what-does-evidence-based-actually-mean\/\" target=\"_blank\" rel=\"noopener\">What does evidence-based actually mean?<\/a><br \/>\r\n<p style=\"text-align: left;\"><a class=\"fasc-button fasc-size-large fasc-type-glossy fasc-rounded-medium\" style=\"background-color: #bd117b; color: #ffffff;\" target=\"_blank\" rel=\"noopener\" href=\"https:\/\/bestpractice.bmj.com\/info\/toolkit\/ebm-toolbox\/bibliography\/\">&nbsp;Read more<\/a><\/p><br \/>\r\n<br \/>\r\n<h3>References<\/h3><br \/>\r\n<ol><br \/>\r\n \t<li>Evidence-based Medicine Working Group. Evidence-based medicine.&nbsp; A new approach to teaching the practice of medicine. JAMA 1992;268:2420-5.<\/li><br \/>\r\n \t<li>Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: How to practice and teach it, 4th ed. Churchill Livingstone, Elsevier: Edinburgh, 2011.<\/li><br \/>\r\n \t<li>Edwards P. A cabinet that looks like Canada:\u2019 Justin Trudeau pledges government built on trust: Toronto Star Newspaper; 2015. Available from: <a href=\"https:\/\/www.thestar.com\/news\/canada\/2015\/11\/04\/new-government-to-be-sworn-in-today.html\" target=\"_blank\" rel=\"noopener\">https:\/\/www.thestar.com\/news\/canada\/2015\/11\/04\/new-government-to-be-sworn-in-today.html.<\/a><\/li><br \/>\r\n \t<li>Malterud K, Bjelland AK, Elvbakken KT. Evidence-based medicine \u2013 an appropriate tool for evidence-based health policy? A case study from Norway. Health Research Policy and Systems. 2016;14(1):15.<\/li><br \/>\r\n \t<li>The JAMA Network. Evidence Based Medicine: An Oral History 2014. Available from: <a href=\"https:\/\/ebm.jamanetwork.com\/\" target=\"_blank\" rel=\"noopener\">https:\/\/ebm.jamanetwork.com\/<\/a>.<\/li><br \/>\r\n \t<li>The James Lind Library. Illustrating the development of fair tests of treatments in health care 2003. Available from: <a href=\"https:\/\/www.jameslindlibrary.org\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.jameslindlibrary.org\/<\/a>.<\/li><br \/>\r\n \t<li>Simpkin AL, Schwartzstein RM. Tolerating Uncertainty \u2014 The Next Medical Revolution? N Engl J Med 2016; 375(18):1713-1715.<\/li><br \/>\r\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>Evidence-based medicine (EBMa) refers to the application of the best available research to clinical care, which requires the integration of evidence with clinical expertise and patient values.[1][2]&nbsp; By best available research, we mean clinically relevant (i.e., patient oriented) research that: Illuminates the accuracy and precision of diagnostic tests, Highlights the importance of prognostic markers, Establishes [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":3005,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"marketing_new.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3006","page","type-page","status-publish","hentry"],"acf":{"components":[{"choose_component":"generic","hide":"","logged_in":["yes"],"logged_out":"","grey_background":"","background_color":"","background_image":null,"title_text_color":"","title":"What is EBM?","text":"<h1 class=\"lead\">Evidence-based medicine (EBM<sup>a<\/sup>) refers to the application of the best available research to clinical care, which requires the integration of evidence with clinical expertise and patient values.[1][2] By best available research, we mean clinically relevant (i.e., patient oriented) research that:<\/h1>\r\n<ul>\r\n \t<li>Illuminates the accuracy and precision of diagnostic tests,<\/li>\r\n \t<li>Highlights the importance of prognostic markers,<\/li>\r\n \t<li>Establishes the efficacy and safety of therapeutic, rehabilitative, or preventive healthcare strategies, or<\/li>\r\n \t<li>Seeks to understand the patient experience.<\/li>\r\n<\/ul>\r\nPhysicians must use their clinical skills and prior experience to rapidly identify each patient\u2019s unique clinical situation, applying the evidence tailored to the individual\u2019s risks versus benefits of potential interventions. Ultimately, the normative goal of EBM is to support the patient by contextualizing the evidence with their preferences, concerns, and expectations. This results in a process of <a href=\"https:\/\/bestpractice.bmj.com\/info\/us\/evidence\/practise-ebm\/shared-decision\/\" target=\"_blank\" rel=\"noopener\">shared decision making<\/a>, in which the patient\u2019s values, circumstances, and setting dictate the best care.\r\n\r\nThe widespread use of EBM in many healthcare disciplines<sup>b\u00a0<\/sup> reflects its broad impact. EBM is also an important tool for social justice. If applied appropriately, it has the potential to be a great equalizer \u2013 striving for equitable care for patients in disparate parts of the world. Furthermore, EBM plays a prominent role in policy making; politicians are increasingly speaking to their use of research evidence to inform their decision making as a declaration of legitimacy.[3][4]\r\n\r\nIts history has been artfully described in \u2018an oral history of EBM\u2019, presented by Dr. Richard Smith, which includes discussions with the founders of EBM \u2013 including Drs David Sackett, Brian Haynes, and Gordon Guyatt.[5] Interested readers can also reference the James Lind Library, which outlines many seminal moments in EBM history.[6]\u00a0 The bottom line of these articles is that EBM is not a new concept but rather it reflects the work of countless people who have improved the process of generating clinical evidence over several decades, and that it continues to evolve.\r\n\r\nDeveloping the skills to practise EBM requires access to evidence, opportunities to practise, and time. We hope this portal will be a starting point. You might choose to use this resource to become a more savvy consumer of the literature or to become the next person to advance this collective wisdom. Much work remains: finding novel ways to integrate evidence into personal health records for use at the bedside and in the patient\u2019s home, improving strategies for risk communication, and finding ways to learn and practice medicine in the face of uncertainty are ripe for efforts.[7] We hope you\u2019ll join this ongoing conversation.\r\n\r\n<strong>Reena Pattani MD MPH FRCPC<\/strong>\r\nAssistant Professor\r\nDivision of General Internal Medicine\r\nDepartment of Medicine\r\nSt. Michael\u2019s Hospital\r\nUniversity of Toronto\r\n\r\n<strong>Sharon E. Straus MD MSc FRCPC<\/strong>\r\nProfessor\r\nDivision of Geriatric Medicine\r\nDepartment of Medicine\r\nSt. Michael\u2019s Hospital\r\nUniversity of Toronto\r\n\r\nAcknowledgements: SES is funded by a Tier 1 Canada Research Chair.\r\n\r\n<sup>a\u00a0<\/sup>The term EBM is used interchangeably with evidence-based practice or evidence-based health care.\r\n<sup>b\u00a0<\/sup>Occupational therapy, physiotherapy, nursing, dentistry, and complementary medicine, to name a few.\r\n<h3><strong>Related blog<\/strong><\/h3>\r\n<a href=\"https:\/\/bestpractice.bmj.com\/info\/us\/evidence\/discuss-ebm\/what-does-evidence-based-actually-mean\/\" target=\"_blank\" rel=\"noopener\">What does evidence-based actually mean?<\/a>\r\n<h3><strong>References<\/strong><\/h3>\r\n<ol>\r\n \t<li>Evidence-based Medicine Working Group. Evidence-based medicine.\u00a0 A new approach to teaching the practice of medicine. JAMA. 1992;268:2420-5.<\/li>\r\n \t<li>Straus SE, Glasziou P, Richardson WS, et al. Evidence-based medicine: How to practice and teach it, 4th ed. Churchill Livingstone, Elsevier: Edinburgh, 2011.<\/li>\r\n \t<li>Edwards P. <a href=\"https:\/\/www.thestar.com\/news\/canada\/2015\/11\/04\/new-government-to-be-sworn-in-today.html.\">A cabinet that looks like Canada: Justin Trudeau pledges government built on trust<\/a>: Toronto Star Newspaper; 2015.<\/li>\r\n \t<li>Malterud K, Bjelland AK, Elvbakken KT. Evidence-based medicine \u2013 an appropriate tool for evidence-based health policy? A case study from Norway. Health Research Policy and Systems. 2016;14(1):15.<\/li>\r\n \t<li>The JAMA Network. <a href=\"https:\/\/ebm.jamanetwork.com\/.\">Evidence Based Medicine: An Oral History<\/a>. 2014.<\/li>\r\n \t<li>The James Lind Library. <a href=\"https:\/\/www.jameslindlibrary.org\/.\">Illustrating the development of fair tests of treatments in health care<\/a>. 2003.<\/li>\r\n \t<li>Simpkin AL, Schwartzstein RM. Tolerating Uncertainty \u2014 The Next Medical Revolution? N Engl J Med. 2016; 375(18):1713-5.<\/li>\r\n<\/ol>","image":null,"qr_image":null,"circular_image":null,"button_text":"Read more","button_url":"https:\/\/bestpractice.bmj.com\/info\/us\/evidence\/ebm-toolbox\/bibliography\/","button2_text":"","button2_url":"","video_embed":"","quote":"","quote_author":"","author_job_title":"","feature_iconsimages":null,"bullets":"none","bullet_text":null,"expiration_date":null,"review_type":"normal","reviews":null,"feature_image_cards":null,"feature_icon_cards":null,"podcast_date":null,"podcast_title":"","podcast_text":"","podcast_embed_script":"","campaign_advert_link":"","monthly":{"show_monthly_tab":false,"strikethrough_price":"","price_text":"","per_month_text":"","vat_text":"","subscribe_button_text":"","subscribe_button_link":""},"annual":{"show_annual_tab":false,"packages":null,"default_price":"","default_strikethrough_price":"","default_per_year_text":"","vat_text":"","subscribe_button_text":"","subscribe_button_link":""},"advisory_panel":null,"article_list_fields":null,"subscription_tab_main_heading":"","subscription_tabs":null,"accordion_for_page":null,"embed_code":""},{"choose_component":"bulletList","hide":"","logged_in":["yes"],"logged_out":"","grey_background":[],"background_color":"","background_image":null,"title_text_color":"","title":"Related 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risk<\/a>","bullet_icon_url":""}],"expiration_date":null,"review_type":"normal","reviews":null,"feature_image_cards":null,"feature_icon_cards":null,"podcast_date":null,"podcast_title":"","podcast_text":"","podcast_embed_script":"","campaign_advert_link":"","monthly":{"show_monthly_tab":false,"strikethrough_price":"","price_text":"","per_month_text":"","vat_text":"","subscribe_button_text":"","subscribe_button_link":""},"annual":{"show_annual_tab":false,"packages":null,"default_price":"","default_strikethrough_price":"","default_per_year_text":"","vat_text":"","subscribe_button_text":"","subscribe_button_link":""},"advisory_panel":null,"article_list_fields":null,"subscription_tab_main_heading":"","subscription_tabs":null,"accordion_for_page":null,"embed_code":""},{"choose_component":"generic","hide":"","logged_in":"","logged_out":["yes"],"grey_background":"","background_color":"","background_image":null,"title_text_color":"","title":"Log in or subscribe to access all of BMJ Best 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